Double naso-enteric tubes stenting in afferent limb syndrome with concomitant proximal efferent limb obstruction after loop gastrojejunostomy bypass: a case report

Endoscopic or fluoroscopic guided naso-enteric placement for stenting and decompression has been used in mechanical enteric limb obstruction after gastrectomy or gastric bypass surgery. However, the use of double naso-enteric tube for treatment of multiple enteric limbs obstruction has not been described to date. We present a 61-year-old female with afferent limb syndrome with concomitant efferent limb obstruction which caused by kinking of anastomosis after loop gastrojejunostomy for benign gastric outlet obstruction. Two naso-enteric tubes were placed in efferent limb and afferent limb by endoscopic and fluoroscopic guidance. The patient was able to resume oral intake after 2 weeks of tube placement.